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CNN Live Sunday

Interview With Dr. Anthony Fauci

Aired April 20, 2003 - 18:11   ET

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.

THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.


SOPHIA CHOI, CNN ANCHOR: And joining me now from Washington to try and shed some more light on how and if SARS can actually be contained, Dr. Anthony Fauci, he's director of the National Institute for Allergies and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.
Thanks so much for joining us.

DR. ANTHONY FAUCI, NATL. INSTITUTES OF HEALTH: It's good to be here.

CHOI: So Dr. Fauci, I heard today something about a 14 to 16 hour incubation period with SARS. Is that accurate and if so, how do you contain a disease with such a long period of incubation?

FAUCI: You said 14 to 15 hours? You meant days. The incubation period from the time you are exposed can be anywhere from two days to seven days with a mean of about five days before you get symptoms.

It's generally felt that if you have a contact with someone who has SARS, has the virus, and you go ten full days without getting any symptoms that you've then gone beyond the danger period so ten is about where you want to go.

If you want to push it a few more days further then that's even being more safe. But it's about ten days, the incubation period.

CHOI: Well then how -- that's an even longer period than I had understood earlier. So, how do you contain something like that? If I'm -- if I get SARS today, and I'm walking around and I'm contagious, I might not know it for several days.

FAUCI: Right, exactly.

CHOI: I'm sorry Dr. Fauci, this news conference we've been waiting on is now beginning, I'm told, so we want to go to that, but I do want to get back to you, so if you can just please stand by.

(INTERRUPTED FOR CNN COVERAGE OF LIVE EVENT)

CHOI: And now I want to get back to Dr. Anthony Fauci. We left him abruptly. We were talking about the SARS cases and how -- and if we can -- contain the SARS virus.

Dr. Fauci, thanks so much for hanging in there with us.

FAUCI: No problem.

CHOI: So we were talking about containing SARS. How is that doable?

FAUCI: Well it's doable by essentially good fundamental public health measures as we in this country particularly through the Centers for Disease Control and Prevention -- the CDC -- have been implementing.

And that is vigilance, that's making sure when people come into the country from high risk countries like China and Hong Kong that you determine if anyone is sick. If they are, you isolate them.

We have not had to implement quarantine at this point but we certainly are ready to do that if appropriate and I underline if appropriate.

Also to make sure that individuals, for example, in this country we recommend that they don't go to countries that are high risk countries like Hong Kong and China unless it's absolutely necessary to travel there and when people are identified that might be suspected of being infected what you do is you treat them accordingly by making sure they're isolated and taking care of them in the appropriate way.

Thus far, that has actually worked relatively well. In fact, quite well in this country. We have 35 highly probable cases in this country. Not a large number but we are certainly ready to make sure that that does not get worse. There's no guarantee it won't, but the public health measures that have been implemented up till now have actually worked quite well.

CHOI: So at this point, the United States is just issuing recommendations. However, some other countries are now promoting travel bans. Do you think it'll come to that in the U.S.?

FAUCI: You know it is totally unpredictable. It is one cannot say because we're in an unusual situation right now that doesn't happen very often where you're actually in the evolutionary phase of an epidemic.

We don't know the direction it's going. We don't know if it's going to take off and skyrocket, or if it's going to plateau and come on down. So it would be not possible nor even appropriate to predict today what we might have to do a week or two or three from now.

It really should keep an open mind and do what is appropriate at the time. What we're doing right now is commiserate with the situation as it is.

CHOI: And to give us some perspective on you know how fast this disease is spreading, can you compare it to maybe some other virus that we've seen in the past that was rapidly spreading?

FAUCI: Well, you know, in some respects you can, but in others you can't because as I mentioned we're still in the evolution of this epidemic so we really don't know what the trajectory is going to be.

But it is spreading as a respiratory-born illness would. And that's one of the reasons why we have always been concerned about emerging and re-emerging microbes, particularly those that are spread by the respiratory root, because one it's easily spread and given the ease of jet travel in the world today you can have a disease start in one part of the world and within a period of hours to days it could be in another part of the world.

We saw that because it began in Quandong (ph) Province in China, went to Hong Kong, and from Hong Kong went to different parts of the world and we now have over two countries that have cases in them.

Generally, for the most part, people who have either been to countries where there's a high risk or have come into contact with individuals who have come from those countries.

CHOI: Let me get your reaction on what we learned about how China had initially handled this virus by downplaying it. What's your reaction being in the health industry?

FAUCI: Well that's really quite unfortunate that that happened and I think the Chinese authorities are very highly regretting that, what they did.

They knew about this in November, several months before it became clear in February and early march that we were dealing with a global problem that had originated in Quandong Province and they have reacted to that, as you know, several officials in the Chinese government have been removed because of that.

So I think they're undergoing a considerable degree of regret for covering up, in some respects, but certainly not being forthcoming in what they knew about it and that's really unfortunate because it may have been a little bit different if they had let us know right from the beginning what was going on.

CHOI: Dr. Fauci, this is a respiratory illness. Take us what happens to your body if you do get SARS.

FAUCI: Well the symptoms when you get this disease it starts off with a fever, you can get a headache, muscle ache, some pains, some feeling of malaise.

Then you get a dry cough and pulmonary symptoms, which are lung symptoms. Shortness of breath and then when you get the severe form you get a pneumonia.

The people who do very poorly, in fact, the people who die, get an overwhelming pneumonia. Which means that they get an infiltrated disease in their lung, in their chest, a combination of the virus itself replicating there but also all of the inflammatory cells that infiltrate the lung in an attempt to suppress the virus.

Some of that inflammatory and immunological response can do as much damage as the virus itself. So it's an overwhelming reaction that hits the lungs and then you can't breathe well and then you get into serious problems.

CHOI: And even healthy young people are dying from this?

FAUCI: Well, yes, obviously if you're an elderly individual or if you have an underlying disease, no matter what the disease is, those types of individuals generally do more poorly than young healthy individuals but in this disease as in some others, you don't have to be elderly, and you don't have to be a frail individual. Some young, healthy individuals have been afflicted and some of them have died.

CHOI: All right, Dr. Fauci, it is an honor to chat with a man with your knowledge. Thank you so much.

FAUCI: You're quite welcome.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com







Aired April 20, 2003 - 18:11   ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
SOPHIA CHOI, CNN ANCHOR: And joining me now from Washington to try and shed some more light on how and if SARS can actually be contained, Dr. Anthony Fauci, he's director of the National Institute for Allergies and Infectious Diseases at the National Institutes of Health in Bethesda, Maryland.
Thanks so much for joining us.

DR. ANTHONY FAUCI, NATL. INSTITUTES OF HEALTH: It's good to be here.

CHOI: So Dr. Fauci, I heard today something about a 14 to 16 hour incubation period with SARS. Is that accurate and if so, how do you contain a disease with such a long period of incubation?

FAUCI: You said 14 to 15 hours? You meant days. The incubation period from the time you are exposed can be anywhere from two days to seven days with a mean of about five days before you get symptoms.

It's generally felt that if you have a contact with someone who has SARS, has the virus, and you go ten full days without getting any symptoms that you've then gone beyond the danger period so ten is about where you want to go.

If you want to push it a few more days further then that's even being more safe. But it's about ten days, the incubation period.

CHOI: Well then how -- that's an even longer period than I had understood earlier. So, how do you contain something like that? If I'm -- if I get SARS today, and I'm walking around and I'm contagious, I might not know it for several days.

FAUCI: Right, exactly.

CHOI: I'm sorry Dr. Fauci, this news conference we've been waiting on is now beginning, I'm told, so we want to go to that, but I do want to get back to you, so if you can just please stand by.

(INTERRUPTED FOR CNN COVERAGE OF LIVE EVENT)

CHOI: And now I want to get back to Dr. Anthony Fauci. We left him abruptly. We were talking about the SARS cases and how -- and if we can -- contain the SARS virus.

Dr. Fauci, thanks so much for hanging in there with us.

FAUCI: No problem.

CHOI: So we were talking about containing SARS. How is that doable?

FAUCI: Well it's doable by essentially good fundamental public health measures as we in this country particularly through the Centers for Disease Control and Prevention -- the CDC -- have been implementing.

And that is vigilance, that's making sure when people come into the country from high risk countries like China and Hong Kong that you determine if anyone is sick. If they are, you isolate them.

We have not had to implement quarantine at this point but we certainly are ready to do that if appropriate and I underline if appropriate.

Also to make sure that individuals, for example, in this country we recommend that they don't go to countries that are high risk countries like Hong Kong and China unless it's absolutely necessary to travel there and when people are identified that might be suspected of being infected what you do is you treat them accordingly by making sure they're isolated and taking care of them in the appropriate way.

Thus far, that has actually worked relatively well. In fact, quite well in this country. We have 35 highly probable cases in this country. Not a large number but we are certainly ready to make sure that that does not get worse. There's no guarantee it won't, but the public health measures that have been implemented up till now have actually worked quite well.

CHOI: So at this point, the United States is just issuing recommendations. However, some other countries are now promoting travel bans. Do you think it'll come to that in the U.S.?

FAUCI: You know it is totally unpredictable. It is one cannot say because we're in an unusual situation right now that doesn't happen very often where you're actually in the evolutionary phase of an epidemic.

We don't know the direction it's going. We don't know if it's going to take off and skyrocket, or if it's going to plateau and come on down. So it would be not possible nor even appropriate to predict today what we might have to do a week or two or three from now.

It really should keep an open mind and do what is appropriate at the time. What we're doing right now is commiserate with the situation as it is.

CHOI: And to give us some perspective on you know how fast this disease is spreading, can you compare it to maybe some other virus that we've seen in the past that was rapidly spreading?

FAUCI: Well, you know, in some respects you can, but in others you can't because as I mentioned we're still in the evolution of this epidemic so we really don't know what the trajectory is going to be.

But it is spreading as a respiratory-born illness would. And that's one of the reasons why we have always been concerned about emerging and re-emerging microbes, particularly those that are spread by the respiratory root, because one it's easily spread and given the ease of jet travel in the world today you can have a disease start in one part of the world and within a period of hours to days it could be in another part of the world.

We saw that because it began in Quandong (ph) Province in China, went to Hong Kong, and from Hong Kong went to different parts of the world and we now have over two countries that have cases in them.

Generally, for the most part, people who have either been to countries where there's a high risk or have come into contact with individuals who have come from those countries.

CHOI: Let me get your reaction on what we learned about how China had initially handled this virus by downplaying it. What's your reaction being in the health industry?

FAUCI: Well that's really quite unfortunate that that happened and I think the Chinese authorities are very highly regretting that, what they did.

They knew about this in November, several months before it became clear in February and early march that we were dealing with a global problem that had originated in Quandong Province and they have reacted to that, as you know, several officials in the Chinese government have been removed because of that.

So I think they're undergoing a considerable degree of regret for covering up, in some respects, but certainly not being forthcoming in what they knew about it and that's really unfortunate because it may have been a little bit different if they had let us know right from the beginning what was going on.

CHOI: Dr. Fauci, this is a respiratory illness. Take us what happens to your body if you do get SARS.

FAUCI: Well the symptoms when you get this disease it starts off with a fever, you can get a headache, muscle ache, some pains, some feeling of malaise.

Then you get a dry cough and pulmonary symptoms, which are lung symptoms. Shortness of breath and then when you get the severe form you get a pneumonia.

The people who do very poorly, in fact, the people who die, get an overwhelming pneumonia. Which means that they get an infiltrated disease in their lung, in their chest, a combination of the virus itself replicating there but also all of the inflammatory cells that infiltrate the lung in an attempt to suppress the virus.

Some of that inflammatory and immunological response can do as much damage as the virus itself. So it's an overwhelming reaction that hits the lungs and then you can't breathe well and then you get into serious problems.

CHOI: And even healthy young people are dying from this?

FAUCI: Well, yes, obviously if you're an elderly individual or if you have an underlying disease, no matter what the disease is, those types of individuals generally do more poorly than young healthy individuals but in this disease as in some others, you don't have to be elderly, and you don't have to be a frail individual. Some young, healthy individuals have been afflicted and some of them have died.

CHOI: All right, Dr. Fauci, it is an honor to chat with a man with your knowledge. Thank you so much.

FAUCI: You're quite welcome.

TO ORDER A VIDEO OF THIS TRANSCRIPT, PLEASE CALL 800-CNN-NEWS OR USE OUR SECURE ONLINE ORDER FORM LOCATED AT www.fdch.com